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General NPI Number Information
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NPI Number | 1710408836
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Entity Type | Organization
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Legal Business Name | FREEDOM MOBILITY CENTER, INC.
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 224 ONEIL CT STE 23
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City | COLUMBIA
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State | SC
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Zip | 29223-7649
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Country | US
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Telephone | 803-807-2999
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Fax | 803-708-1843
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Provider Business Mailing Address
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Address Line | 110 TALBERT POINTE DR
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City | MOORESVILLE
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State | NC
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Zip | 28117-4377
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Country | US
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Telephone | 704-658-0817
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN GILBERT COTHAM
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Credential |
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Telephone | 704-658-0817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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